---
title: "Dentistry Clinical Research Feed | MedicHelpline"
specialty: "Dentistry"
specialty_slug: "dentistry"
canonical_url: "https://medichelpline.com/clinical-feed/dentistry"
content_type: "clinical_feed_specialty"
page: 1
articles_in_batch: 30
generated_at: "2026-09-05T23:52:13.534Z"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Dentistry — Clinical Research Feed
## Specialty Overview: Dentistry
Latest peer-reviewed clinical trials, guidelines, and observational research in **Dentistry**, indexed and structured for clinical intelligence and AI reasoning.
## Latest Dentistry Publications
### 1. [Dental Unit Waterline Safety: Test, Treat, and Document with QuickPass](https://medichelpline.com/clinical-feed/off-the-cusp-0-don-t-let-your-dental-water-close-your-doors.md)
- **Source:** Off the Cusp Clinical | **Published:** 2026-09-04
- **Detail Markdown URL:** [Dental Unit Waterline Safety: Test, Treat, and Document with QuickPass](https://medichelpline.com/clinical-feed/off-the-cusp-0-don-t-let-your-dental-water-close-your-doors.md)

> **Executive GIST:** - Dental unit waterline (DUWL) treatment products alone do not prove compliance; without testing, practices cannot confirm that water meets safety standards. - The CDC recommends water used in routine dental care contain no more than **500 CFU/mL** of heterotrophic bacteria and advises routine monitoring of water quality. - Treated waterlines can fail because treatment efficacy can decline, biofilm can persist, equipment can malfunction, and protocols can lapse. - Recent CDC advisories and outbreak reports (including NTM infections linked to dental care) highlight real patient-safety consequences when practices do not monitor waterlines. - Quantitative testing that reports colony-forming units per milliliter (CFU/mL) is superior to qualitative pass/fail screens for documenting compliance and detecting rising bacterial trends. - **QuickPass®** is presented as an in-office quantitative heterotrophic plate count test that provides CFU/mL results, 48–72 hour in-office results, built-in neutralization, and ProEdge support services. - QuickPass can serve as a documented quarterly waterline test because it reports numeric CFU/mL ranges, helping teams act before near-fails become failures. - ProEdge treatment options include **BluTube®** (cartridge, continuous treatment) and **BluTab®** (daily effervescing tablets); practices should choose one approach and pair it with testing. - A failed test should be treated as actionable information: investigate causes, remediate lines, and retest to confirm correction. Documentation via ProEdge Clear™ helps track results and compliance. - Testing plus consistent treatment creates a complete DUWL protocol to protect patients, maintain practice operations, and provide defensible documentation.

### 2. [Sodium fluoride (NaF) rinse alters species composition of early oral biofilms on enamel and dentine](https://medichelpline.com/clinical-feed/pubmed-42693341.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-04 | DOI: [10.1007/s00784-026-07121-1](https://doi.org/10.1007%2Fs00784-026-07121-1)
- **Detail Markdown URL:** [Sodium fluoride (NaF) rinse alters species composition of early oral biofilms on enamel and dentine](https://medichelpline.com/clinical-feed/pubmed-42693341.md)

> **Executive GIST:** - Objective: To determine whether a single 500 ppm **sodium fluoride (NaF)** rinse modifies the composition of very early oral biofilms formed in situ on human enamel and dentine. - Design: Double-blind, randomized, crossover in situ trial with 12 adult volunteers wearing mandibular appliances that held enamel and dentine specimens. - Procedure: After 1 minute for pellicle formation, participants rinsed for 1 minute with either NaF solution (500 ppm F–) or deionized water, then wore the appliance overnight (~8 hours) to allow early biofilm formation. - Microbiology: Biofilm composition was assessed by full-length 16S rRNA gene sequencing to profile taxa at species level. - Diversity findings: No significant differences in alpha or beta diversity between NaF and control groups; overall community diversity and dominant genera remained stable. - Dominant taxa: Overall dominant genera across specimens were **Streptococcus** (61–71%), Haemophilus (15–24%), Gemella (4–6%), Veillonella (1–3%), and Rothia (1–2%). - Species-level shifts: NaF rinse produced subtle, significant changes at the species level — increasing several **Streptococcus** spp. (including S. salivarius and S. toyakuensis) and decreasing other Streptococcus spp., Neisseria, and Prevotella species. - Surface-specific effects: On enamel, NaF decreased S. gordonii and increased S. oralis and S. parasanguinis; on dentine, NaF was associated with increased Rothia and Haemophilus species. - Interpretation: A single 500 ppm NaF rinse does not alter overall community structure but induces modest, surface-dependent species-level shifts in early oral biofilms formed in situ. - Clinical implications: These exploratory findings suggest potential microbiome modulation by fluoride rinses, but the study did not address functional consequences or direct clinical outcomes; further research is needed. - Trial details and ethics: Registered at ClinicalTrials.gov (NCT04033263); approved by local ethics committee (Project ID 2022-01904); written informed consent obtained. Conflict of interest: one author recused from editorial handling; others declared no conflicts.

### 3. [Behavioral Modification as a Mediator of Digital Therapeutic Response in Temporomandibular Disorde](https://medichelpline.com/clinical-feed/pubmed-42691400.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-03 | DOI: [10.2196/104264](https://doi.org/10.2196%2F104264)
- **Detail Markdown URL:** [Behavioral Modification as a Mediator of Digital Therapeutic Response in Temporomandibular Disorde](https://medichelpline.com/clinical-feed/pubmed-42691400.md)

> **Executive GIST:** - This secondary analysis evaluated whether **behavioral modification** or engagement intensity mediates clinical response to a **digital therapeutic (DTx)** for **temporomandibular disorders (TMDs)** using data from a multicenter, double-blind, sham-controlled randomized superiority trial in South Korea. - The per-protocol sample included 93 participants (DTx, n=44; sham, n=49) drawn from two tertiary care centers. - Investigators integrated multiple data streams: self-reported measures, server-derived engagement metrics, and clinician-rated outcomes to probe mechanisms of treatment response. - The analysis applied five complementary analytic approaches; the abstract lists “responder logistic regressio” before truncation, indicating a range of regression and responder-profile methods were planned. - The study aimed to identify behavioral mechanisms, responder profiles, and moderators that explain why some patients benefit from DTx while others do not. - The report does not provide full methodological details, statistical results, effect sizes, or specific findings in the available abstract text; those details were not reported in the provided source. - Key reported trial features: multicenter, double-blind, sham-controlled randomized superiority design, per-protocol cohort size, and integration of multiple outcome sources. - Because the source abstract is truncated, interpretation must be limited to reported aims, design, and available cohort information; specific conclusions about mediation by behavioral modification or engagement intensity are not available in the provided text. - The analysis addresses an important clinical question: whether a DTx exerts benefit via changing patient behavior versus simply reflecting higher engagement, with implications for tailoring and optimizing DTx for **TMD** management.

### 4. [Air‑abrasion Pretreatment Improves Retention of Giomer‑Based Pit and Fissure Sealants: 12‑Month RCT](https://medichelpline.com/clinical-feed/pubmed-42687162.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-03 | DOI: [10.1186/s12903-026-09691-8](https://doi.org/10.1186%2Fs12903-026-09691-8)
- **Detail Markdown URL:** [Air‑abrasion Pretreatment Improves Retention of Giomer‑Based Pit and Fissure Sealants: 12‑Month RCT](https://medichelpline.com/clinical-feed/pubmed-42687162.md)

> **Executive GIST:** - This randomized parallel‑arm clinical trial evaluated whether **bioactive glass air‑abrasion** pretreatment improves retention and caries prevention of a **giomer‑based pit and fissure sealant** over 12 months. - Ninety‑six participants were enrolled; each contributed one sound permanent molar (48 teeth per group). Participants were randomized to intervention (air‑abrasion + giomer sealant) or comparator (giomer sealant without pretreatment). - Outcomes assessed at baseline, 6 months, and 12 months included sealant retention (primary outcome) using Simonsen's criteria and secondary caries incidence using modified USPHS criteria. - At 6 months, complete retention was 91.7% in the intervention group versus 75.0% in the comparator group; this difference did not reach statistical significance (p = 0.068). - At 12 months, complete sealant retention was significantly higher with air‑abrasion pretreatment (87.5%) compared with no pretreatment (33.3%) (p < 0.0001). - Relative risk analysis showed an 81.25% lower risk of sealant retention failure in the intervention group versus comparator (RR = 0.1875; 95% CI: 0.0864–0.4069; p < 0.0001). - No difference in secondary caries incidence between groups was detected during 12 months (p = 1.0000). - Trial was registered (NCT06003452) and conducted with ethics approval from the Research Ethics Committee, Faculty of Dentistry, Cairo University; authors declared no competing interests. - The study concludes that mechanical conditioning with **bioactive glass air‑abrasion** before placing a **giomer** sealant significantly improves retention at 12 months without affecting short‑term caries outcomes.

### 5. [Eubacterium saphenum and Periodontitis: Systematic Review Linking Detection to Disease Severity](https://medichelpline.com/clinical-feed/plos-one-19-association-between-eubacterium-saphenum-and-periodontitis-a-systematic-review.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-09-02
- **Detail Markdown URL:** [Eubacterium saphenum and Periodontitis: Systematic Review Linking Detection to Disease Severity](https://medichelpline.com/clinical-feed/plos-one-19-association-between-eubacterium-saphenum-and-periodontitis-a-systematic-review.md)

> **Executive GIST:** - This systematic review assessed the association between **Eubacterium saphenum** and periodontitis, asking whether the taxon is more frequently detected or enriched in disease and whether abundance increases with severity. - The review followed PRISMA 2020 guidance and was prospectively registered in PROSPERO (CRD420251273182). - Inclusion criteria: observational studies of systemically healthy adults comparing periodontitis cases and periodontal health, reporting detection or relative abundance of **E. saphenum** in subgingival biofilm and/or saliva. - Searches covered multiple databases (PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, Google Scholar) with no date limits; first 200 Google Scholar results screened. - Eight observational studies met criteria, comprising 304 healthy controls and 510 periodontitis cases from Asia, Europe, and the Americas. - Detection platforms varied (PCR-based assays and high-throughput sequencing among those reported); across platforms, **E. saphenum** tended to be more frequently detected or present at higher relative abundance in periodontitis than in health. - Studies using the 2018 periodontal classification and reporting stage-specific analyses generally found higher detection or enrichment of **E. saphenum** in advanced disease (stages III–IV). - Quality and certainty: study quality was appraised with the AXIS tool; certainty of evidence was rated as low using GRADE due to observational and largely cross-sectional designs, methodological heterogeneity, and absent temporality. - Authors conclude a low-certainty positive directional association between **E. saphenum** and periodontitis—especially Stage III–IV—but note that longitudinal, interventional, and mechanistic studies are needed to establish temporality or functional contribution. - The review interprets findings within a polymicrobial dysbiosis framework and emphasizes that current evidence supports association, not causation.

### 6. [DentalPair-Cert: Enhancing Rigorous Comparison Between Dental AI and Dentists](https://medichelpline.com/clinical-feed/medrxiv-14-can-dental-ai-really-beat-dentists-dentalpair-cert-for-rigorous-ai-dentist.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-09-02
- **Detail Markdown URL:** [DentalPair-Cert: Enhancing Rigorous Comparison Between Dental AI and Dentists](https://medichelpline.com/clinical-feed/medrxiv-14-can-dental-ai-really-beat-dentists-dentalpair-cert-for-rigorous-ai-dentist.md)

> **Executive GIST:** - This study addresses the methodology of comparing **dental AI systems** and dentists in diagnostic accuracy using paired radiograph readings. - Traditional comparative studies report AI and dentist accuracies separately against a reference, omitting the joint correctness pattern needed for proper paired inference. - Such omission leads to incomplete understanding, where accuracy differences are identified but their uncertainty cannot be reliably estimated. - Analysis of a sample of 282 units revealed that published accuracy figures correspond to 38 possible joint outcome tables, causing variability in confidence interval widths by a factor of 2.5. - The decision framework for interpreting AI versus dentist performance is divided into three zones: non-significant difference, indeterminate zone, and significant difference. - The key missing data point is the count of units both AI and dentist correctly classify, which enables exact joint tables and restores standard paired analysis. - For multi-reader panels, joint-correct counts tighten inference bounds and reduce uncertainty significantly. - The authors present DentalPair-Cert, a certification method that provides finite-sample coverage for all admissible AI-dentist dependence models, ensuring reliable interval estimates. - Simulation studies over 4.2 million comparisons showed that ignoring paired dependency leads to poor coverage and increased type-I error rates. - A review of 9 recent studies showed a lack of proper paired tests on discordant units, underscoring the need for improved reporting standards. - Overall, the study highlights the critical importance of publishing joint-correct counts to enable rigorous, reproducible comparisons of dental AI and human experts.

### 7. [Microsurgical versus conventional surgery for gingival recession with collagen matrix: randomized](https://medichelpline.com/clinical-feed/pubmed-42664116.md)
- **Source:** PubMed / NCBI | **Published:** 2026-09-01 | DOI: [10.7417/CT.2026.2096](https://doi.org/10.7417%2FCT.2026.2096)
- **Detail Markdown URL:** [Microsurgical versus conventional surgery for gingival recession with collagen matrix: randomized](https://medichelpline.com/clinical-feed/pubmed-42664116.md)

> **Executive GIST:** - This randomized split-mouth clinical trial compared **microsurgery** (3.5X magnification) with **conventional surgery** for treating gingival recession using a **collagen matrix**. - Study population: 29 patients with bilateral gingival recession in the maxillary canine and/or premolar region; sites randomized to test (microsurgery) or control (conventional surgery). - Clinical and patient-reported outcomes were recorded at baseline, 1, 3 and 6 months. - Both groups achieved statistically significant improvements at 6 months in gingival recession height (GRH), gingival recession width (GRW), clinical attachment level gain (CAL gain), keratinized tissue thickness (KTT) and keratinized tissue width (KTW). - Intergroup comparisons of clinical parameters showed no significant differences between microsurgical and conventional approaches. - Patient-centred outcomes (patient satisfaction score, hypersensitivity score, root aesthetic scores) were significantly better with the **microsurgical** approach. - Authors conclude both techniques provide comparable clinical improvement, but the **microsurgical** approach produced superior patient-reported outcomes; choice of technique should balance patient needs with cost, time, and clinician expertise. - Trial published by Perambudhuru et al., Clin Ter. 2026; affiliations include the Division of Periodontology and Department of Anatomy at All India Institute of Medical Sciences (AIIMS) Bathinda and AIIMS Delhi. PMID: 42664116.

### 8. [Social media addiction, maternal mental health, and immigrant children’s oral health behaviours](https://medichelpline.com/clinical-feed/plos-one-20-social-media-addiction-maternal-mental-health-and-children-s-oral-health.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-27
- **Detail Markdown URL:** [Social media addiction, maternal mental health, and immigrant children’s oral health behaviours](https://medichelpline.com/clinical-feed/plos-one-20-social-media-addiction-maternal-mental-health-and-children-s-oral-health.md)

> **Executive GIST:** - This cross-sectional study of 302 immigrant parent–child pairs in Edmonton, Canada, examined associations between **maternal anxiety and depression**, **social media addiction**, and children’s oral health behaviours (OHBs): dental visits, toothbrushing, and diet. - Mothers’ mean age was 37.7 years and children’s mean age was 6.7 years; 49% of children were female and 65% were born in Canada. Parents had lived in Canada a mean of 9.9 years; 68% reported higher education. - Maternal anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS-14). Social media addiction was assessed with the Bergen-6 scale. - Higher maternal anxiety was associated with reduced odds of child toothbrushing: each unit increase in anxiety corresponded to a 14% reduction in the odds of regular toothbrushing (OR 0.86, 95% CI 0.74–0.98). - Higher maternal depression was associated with a 21% reduction in the odds of child toothbrushing (OR 0.79, 95% CI 0.63–0.93). - Each one-unit increase in maternal anxiety and depression was associated with increases in social media addiction scores (approximately 49% and 51% increases reported; p < .05 for these associations as reported). - Analyses found no evidence that **social media addiction** mediated or moderated the relationship between maternal mental health and children’s oral health behaviours. - The authors conclude that maternal anxiety and depression reduce children’s toothbrushing and recommend integrating mental health screening into dental care for immigrant communities to support better oral health outcomes. - Data collection occurred 2021–2024 with ethical approval from the University of Alberta Health Research Ethics Board; 302 questionnaires were analyzed. Funding was provided by the Oral Health Children, Youth & Families Fund (OHCYFF).

### 9. [Retraction: Sensory art therapies for dental anxiety — PLOS One systematic review withdrawn](https://medichelpline.com/clinical-feed/plos-one-10-retraction-effect-of-sensory-art-therapies-on-root-canal-treatment-anxiety-and.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-27
- **Detail Markdown URL:** [Retraction: Sensory art therapies for dental anxiety — PLOS One systematic review withdrawn](https://medichelpline.com/clinical-feed/plos-one-10-retraction-effect-of-sensory-art-therapies-on-root-canal-treatment-anxiety-and.md)

> **Executive GIST:** - A PLOS One systematic review and meta-analysis titled “Effect of sensory art therapies on root canal treatment anxiety and high dental anxiety in adults” was retracted by the PLOS One Editors following methodological concerns raised after publication. The retraction notice lists multiple specific problems that undermine the validity and reliability of the reported results. - Major concerns included excessive heterogeneity from combining diverse interventions under the umbrella term **sensory art therapies** (virtual reality, aromatherapy, music therapy, chromotherapy, yoga, aerobic exercise), which reduces interpretability of pooled effects and the validity of meta-analytic pooling. - At least one included study did not meet the predefined participant criteria in the review’s PICOS framework: it enrolled routine dental care patients with a range of anxiety levels rather than adults specifically undergoing root canal treatment or with high dental anxiety/dental phobia. - Two included studies evaluated interventions (aerobic exercise and yoga) that do not match the review’s defined intervention type (sensory-based art therapies). Those two studies were not included in the meta-analysis, but their inclusion in the review raised concerns about selection criteria consistency. - The review reported eight outcome-specific meta-analyses, each based on a small number of studies (n = 2–6). Multiple subgroup entries from the same studies were included in several outcomes, risking disproportionate influence of single studies on pooled estimates. - There was an inconsistency in reported **GRADE** certainty for heart rate between figure and table, and the authors reported upgrading certainty for some outcomes (VAS, HR, salivary cortisol) based on effect size magnitude. Editorially, upgrading for RCTs on that basis is not permitted, changing the overall certainty range from the report’s “very low to high” to “very low to low.” - One study was entered multiple times in a meta-analysis (four entries for the same study vs the same 30-person control group), representing repeated measurements from the same participants as independent data points. This violates the independence assumption of meta-analysis and inflates sample size and weight. - PLOS One sought independent expert and statistical advice; both advisors agreed the validity and reliability of the published results were in question, prompting the Editors to retract the article. Three authors responded without stating agreement or disagreement; one author was unreachable or did not respond. - The retraction notice cites the original article and the included studies involved in the concerns and clarifies that the editors withdrew the paper because of the methodological issues documented.

### 10. [Dental Practice Renovation: Revitalizing a 40-Year Practice into Smiles by Design](https://medichelpline.com/clinical-feed/off-the-cusp-0-building-new-life-into-an-old-practice.md)
- **Source:** Off the Cusp Clinical | **Published:** 2026-08-25
- **Detail Markdown URL:** [Dental Practice Renovation: Revitalizing a 40-Year Practice into Smiles by Design](https://medichelpline.com/clinical-feed/off-the-cusp-0-building-new-life-into-an-old-practice.md)

> **Executive GIST:** - Dr. Justin Smutz purchased a 40-year-old dental practice in Arvada, Colorado and opted to fully gut and renovate the building rather than perform minor updates. - The original facility was dated across many aspects; Dr. Smutz considered location important and chose to rebuild on the same site. - The entire practice was transformed into Smiles by Design, with comprehensive updates to clinical spaces, an in-house lab, and a dedicated sterilization center. - Equipment decisions prioritized longevity; Dr. Smutz selected **A-dec** based on observing older practices that retained A-dec equipment for decades. - Dr. Smutz partnered with Patterson and its equipment specialist Lonnie Gwynn for planning, procurement, delivery, installation, and ongoing support. - Patterson’s role included coordinating vendors, providing skilled technicians for technology service, and offering practice support through teams like TechEdge. - The remodel has coincided with substantial practice growth: reported production has quadrupled since the renovation. - Dr. Smutz emphasizes non-financial measures of success, valuing bringing refined, high-end dental services to his hometown community. - The in-house lab keeps restorations “inside the walls,” which Dr. Smutz highlights as a point of pride and control over quality. - The sterilization center was intentionally designed to give staff appropriate space and pride in infection-control workflows; staff appreciation was noted. - Dr. Smutz describes the project as a team effort and expressed strong trust in Patterson for vision-to-delivery support and ongoing relationships. - After completion, Dr. Smutz conveyed gratitude to his Patterson team, calling the office “beyond my dream.” - The source references additional media (a video and an article) to view the remodel and learn more; specific details of those resources were noted but not reproduced in the source.

### 11. [Mucoadhesive Patch vs Benzocaine Gel for Reducing Dental Injection Pain: Split-Mouth RCT](https://medichelpline.com/clinical-feed/pubmed-42625076.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-21 | DOI: [10.1007/s10006-026-01615-8](https://doi.org/10.1007%2Fs10006-026-01615-8)
- **Detail Markdown URL:** [Mucoadhesive Patch vs Benzocaine Gel for Reducing Dental Injection Pain: Split-Mouth RCT](https://medichelpline.com/clinical-feed/pubmed-42625076.md)

> **Executive GIST:** - This split-mouth randomized clinical trial compared a novel **20% benzocaine mucoadhesive patch** with a standard 20% benzocaine gel for reducing pain from maxillary dental injections. - The study enrolled 36 healthy patients undergoing bilateral maxillary tooth extractions at Mashhad University of Medical Sciences. - The mucoadhesive patch had a bilayer design: a chitosan–gelatin–glycerin base layer and an adhesive layer containing sodium carboxymethylcellulose, gelatin, pectin, 20% benzocaine, and methylene blue. - Interventions: benzocaine gel applied for 30 seconds versus the mucoadhesive patch applied for 10 minutes at buccal and palatal sites; a 10-minute washout interval separated left and right side anesthetic procedures. - Pain outcomes were recorded using the observer-rated **SEM** (Sound, Eye, Motor) scale and patient-reported **NRS-11** (11-point Numeric Rating Scale). - Statistical tests included Shapiro–Wilk, Wilcoxon signed-rank, Mann–Whitney U, and Spearman correlation with α = 0.05. - Results: NRS-11 scores were significantly lower with the patch for both buccal and palatal injections (P < 0.05). SEM scores were significantly lower with the patch at the palatal site (P = 0.011) but not at the buccal site (P = 0.075). - Sex, age, and baseline anxiety (Beck Anxiety Inventory) did not correlate with pain scores. - The authors conclude the **20% benzocaine mucoadhesive patch** reduced self-reported pain for buccal and palatal injections and observer-rated pain for palatal injections versus benzocaine gel. - Trial registration: Iranian Registry of Clinical Trials IRCT20230125057218N1 (registered 10 October 2023).

### 12. [Removal of overextended gutta-percha in mandibular premolars: XP-endo Retreatment vs ProTaper vs H](https://medichelpline.com/clinical-feed/pubmed-42618907.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-20 | DOI: [10.1186/s12903-026-09571-1](https://doi.org/10.1186%2Fs12903-026-09571-1)
- **Detail Markdown URL:** [Removal of overextended gutta-percha in mandibular premolars: XP-endo Retreatment vs ProTaper vs H](https://medichelpline.com/clinical-feed/pubmed-42618907.md)

> **Executive GIST:** - This in vitro comparative study evaluated the time required to remove **overextended gutta-percha** from extracted mandibular premolars using three retreatment approaches: manual Hedstrom files (H-files), ProTaper Universal Retreatment (PTUR) rotary files, and an XP-endo Retreatment (XPER) approach combining XP-endo Shaper and XP-endo Finisher R. - Thirty-six extracted permanent mandibular premolars with single canals were standardized to 19 mm total length and intentionally prepared 3 mm beyond the apical foramen up to the F2 file of the ProTaper Gold system to create overextension. - Overextended obturation used a size 25/08 gutta-percha cone with an epoxy resin–based sealer (AH-Plus) placed by cold lateral condensation. Specimens were stored 7 days to allow sealer setting before retreatment. - Teeth were randomized into three equal groups (n = 12) by removal technique: Group I (H-files), Group II (PTUR), Group III (XPER: XP-endo Shaper + XP-endo Finisher R). The primary outcome was procedural time to complete removal of the overextended filling. - Results reported a statistically significant reduction in removal time with the **XPER** technique compared with both **H-files** and **PTUR** (P PTUR > H-files (slowest). - Authors conclude the **XP-endo Retreatment** technique achieved superior procedural time efficiency in removing experimentally overextended gutta-percha compared with manual Hedstrom files and ProTaper Universal Retreatment files. - The study received ethical approval from Alexandria University, followed the Declaration of Helsinki for donated extracted teeth, and authors declared no competing interests. - Key indexed terms include mandibular premolars, overextended obturation, retreatment, gutta-percha, epoxy resin–based sealer, and time factors; the article is a comparative in vitro study published in BMC Oral Health.

### 13. [How CAD/CAM and 3D Printing Transformed Patient Care at Premier Institute of Oral and Facial Surge](https://medichelpline.com/clinical-feed/off-the-cusp-0-partnering-for-success.md)
- **Source:** Off the Cusp Clinical | **Published:** 2026-08-19
- **Detail Markdown URL:** [How CAD/CAM and 3D Printing Transformed Patient Care at Premier Institute of Oral and Facial Surge](https://medichelpline.com/clinical-feed/off-the-cusp-0-partnering-for-success.md)

> **Executive GIST:** - Dr. Alexander Heatrice designed the Premier Institute of Oral and Facial Surgery to combine an inviting environment with high-end clinical equipment to help patients feel at ease and receive optimal care. - From the start he sought a long-term collaborator rather than a simple equipment vendor; early conversations with Vince Sciore, a **Patterson** CAD/CAM specialist, focused on improving the patient experience. - The practice team adopted **3D printing** as the first major technology purchase to enable same-day provisionals for implant surgery. - Providing provisional implants on the day of surgery supports immediate esthetic results and is central to the patient experience Dr. Heatrice values. - The practice is a leading provider of arches in the St. Louis area, regularly sending patients home with immediate restorations. - Many patients present with embarrassment and insecurity about their mouth; the **CAD/CAM** workflow allows accurate scans, measurements, and design templates that expedite restorative care. - Dr. Heatrice describes strong emotional reactions from patients who receive provisional restorations the same day, noting that patients often cry and say the change has transformed their lives—even before the final prosthesis is placed. - Dr. Heatrice credits the collaborative, team-based approach with easing pressure on the practice and increasing chances of success. - He relies on recommendations from his trusted **Patterson** team when considering new technologies, expressing openness to technologies that could help the practice succeed. - The practice’s success is deeply personal for Dr. Heatrice; he describes moments of emotion at the end of the day when reflecting that he is living a long-held professional dream. - The source mentions additional topics in Dr. Heatrice’s story—other technologies that set his practice apart and insights about being married to a pediatric dentist who owns her own practice—but details were not reported in the source.

### 14. [Goat TMJ osteochondral defect model for testing regenerative therapies in TMJ‑OA](https://medichelpline.com/clinical-feed/plos-one-15-goat-temporomandibular-joint-osteochondral-defects-for-future-regenerative.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-19
- **Detail Markdown URL:** [Goat TMJ osteochondral defect model for testing regenerative therapies in TMJ‑OA](https://medichelpline.com/clinical-feed/plos-one-15-goat-temporomandibular-joint-osteochondral-defects-for-future-regenerative.md)

> **Executive GIST:** - The study establishes a large‑animal **goat** model of temporomandibular joint osteochondral defects (OCDs) to support preclinical testing of regenerative treatments for **TMJ‑OA**. - Two reproducible defect geometries were compared: a novel retrograde **tunnel defect** drilled from the posterior condyle to the articular surface, and a conventional anterograde **superior defect** drilled from the joint surface. - Defects were critically sized: neither defect showed complete subchondral bone healing nor cartilage regeneration up to **60 days** post‑surgery. - All defects were filled predominantly with fibrous tissue and showed peripheral formation of woven bone, indicating impaired osteochondral repair. - Surrounding articular fibrocartilage exhibited **OA‑like degeneration** per the modified **OARSI** scale, including loss of normal zonal structure (fibrous, transition, cartilaginous layers). - The **tunnel defect** offers procedural advantages: it preserves disc attachments, reduces TMJ manipulation, and enables creation of larger defects while producing similar impaired healing and OA‑like changes as the superior defect. - Goats are favored as a translational large‑animal TMJ model due to joint size, biomechanical loading from prolonged rumination, and surgical accessibility compared with porcine models. - The model is presented as a practical preclinical platform for evaluating implantable regenerative constructs and strategies targeting condylar regeneration in TMJ‑OA.

### 15. [Genomic and proteomic links between childhood dental caries and cardiometabolic disease risk](https://medichelpline.com/clinical-feed/medrxiv-11-genomic-and-proteomic-evidence-linking-dental-caries-in-childhood-and.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-19
- **Detail Markdown URL:** [Genomic and proteomic links between childhood dental caries and cardiometabolic disease risk](https://medichelpline.com/clinical-feed/medrxiv-11-genomic-and-proteomic-evidence-linking-dental-caries-in-childhood-and.md)

> **Executive GIST:** - A large genome-wide association study (GWAS) of objectively measured **dental caries** in permanent dentition among Danish children and adolescents (DCCA) (N = 151,521) identified **14 independent loci** associated with caries. - Genes at DCCA-associated loci showed enriched expression in **immune**, secretory and epithelial cell populations, suggesting biological pathways connecting oral biology and systemic processes. - The study reports genetic correlations and evidence for **shared causal variants** between DCCA and several **cardiometabolic traits**, indicating partial overlap in genetic architecture. - Using data from UK Biobank (Nmax = 501,936) and independent pediatric cohorts (Nmax = 3,412), genetic liability to DCCA associated with adult outcomes including use of **dentures**, **coronary artery disease**, and **type 2 diabetes**. - Associations were also observed with continuous biomarkers: HbA1c, lipid measures, liver enzyme levels, and plasma proteins implicated in oral, metabolic and hepatic biology in both populations. - The work integrates **genomic** signals with **proteomic** and phenotypic data to provide mechanistic insight into how childhood and adolescent caries liability may relate to later-life cardiometabolic disease risk. - Summary statistics from the GWAS will be deposited to the GWAS Catalog on publication; individual-level HOLBAEK study data are restricted by GDPR but may be available on request to the corresponding author with appropriate approvals. - Ethical approvals and participant consent were obtained from relevant Danish committees and studies; analytical code for UK Biobank analyses is available in two public GitHub repositories referenced in the source. - The study emphasizes emerging evidence that oral and systemic health are interconnected and provides new genetic and proteomic data to better understand that relationship.

### 16. [Long-term Outcomes of Tunnel Technique with Subepithelial Connective Tissue Graft for Gingival Rec](https://medichelpline.com/clinical-feed/medrxiv-16-long-term-clinical-performance-of-the-tunnel-technique-with-subepithelial.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-18
- **Detail Markdown URL:** [Long-term Outcomes of Tunnel Technique with Subepithelial Connective Tissue Graft for Gingival Rec](https://medichelpline.com/clinical-feed/medrxiv-16-long-term-clinical-performance-of-the-tunnel-technique-with-subepithelial.md)

> **Executive GIST:** - This retrospective cohort assessed the long-term clinical performance of a minimally invasive **tunnel technique** combined with **subepithelial connective tissue graft (SCTG)** for root coverage under routine practice conditions. - The study included 74 patients (57 women, 17 men) contributing 710 gingival recession sites treated between 2009 and 2025. - Enamel matrix derivative (EMD) was used in selected cases; exact selection criteria were not reported in the source. - The source reports a mean follow-up value that is unclear in wording (“6.0 for 4.0 years”), with a maximum observation period of 16 years; the precise mean and spread are not clearly stated in the manuscript text provided. - Primary outcome was reduction in recession depth; mean recession reduction reported was **2.72 mm**. - Secondary outcomes included **complete root coverage (CRC)**, mean root coverage, and long-term marginal stability; CRC was achieved at **83.4%** of treated sites. - Clinically relevant relapse was predefined as a ≥1 mm increase in recession after initial healing; at final follow-up no treated site showed such relapse and no site deteriorated beyond baseline recession. - Treatment effects were observed across both anterior and posterior regions; specific subgroup data were not detailed in the source text. - Authors conclude tunnel surgery with SCTG shows high predictability and durable marginal soft-tissue stability up to 16 years, supporting phenotype-enhancing, minimally invasive soft-tissue augmentation for localized and multiple recessions. - Ethical oversight and consent procedures were declared; the Ethics Committee letter and data source (Charly PH Patient Data Management System) were cited. Competing interests were declared none.

### 17. [Interprofessional education curriculum and dental students' understanding of interdisciplinarity v](https://medichelpline.com/clinical-feed/medrxiv-19-interprofessional-education-curriculum-and-the-knowledge-of-interdisciplinarity.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-17
- **Detail Markdown URL:** [Interprofessional education curriculum and dental students' understanding of interdisciplinarity v](https://medichelpline.com/clinical-feed/medrxiv-19-interprofessional-education-curriculum-and-the-knowledge-of-interdisciplinarity.md)

> **Executive GIST:** - This retrospective cross-sectional study evaluated senior undergraduate dental students' understanding of **interdisciplinarity** and **multidisciplinarity** within an interprofessional education (IPE) context at the UBC Faculty of Dentistry. - Three consecutive cohorts (2021/22–2023/24; N = 177 enrolled) completed a short assessment question; 164 students provided usable responses. - Respondents: 60 in 2021/22, 51 in 2022/23, 53 in 2023/24; mean age was 25 years; 88 respondents were female. - Open responses (maximum 100 words) were coded into four predetermined themes: **concordant knowledge** (both definitions correct), **discordant rhetoric** (both incorrect), **switched ideas** (definitions reversed), and **altered discourse** (conflation of discipline and specialty). - Distribution of themes: 45.7% concordant knowledge, 15.9% discordant rhetoric, 18.3% switched ideas, and 20.1% altered discourse. - Logistic regression found older age associated with higher probability of providing correct definitions (adjusted OR = 1.39; 95% CI: 1.06–1.83; p = 0.017). - Authors conclude that a majority of students retained knowledge of the two concepts but recommend continued inclusion of **interprofessional education** through didactic and experiential learning to prepare students for collaborative practice. - Ethical approval was granted by the University of British Columbia Behavioural Research Ethics Board (H25-01322). The study is a medRxiv preprint and has not been peer reviewed. - All study data are available from the authors upon reasonable request.

### 18. [Micro-CT Analysis of Voids in Ultrasonically Activated Calcium Silicate Sealers](https://medichelpline.com/clinical-feed/plos-one-22-ultrasonic-activation-of-calcium-silicate-sealers-in-single-cone-obturation-a.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-14
- **Detail Markdown URL:** [Micro-CT Analysis of Voids in Ultrasonically Activated Calcium Silicate Sealers](https://medichelpline.com/clinical-feed/plos-one-22-ultrasonic-activation-of-calcium-silicate-sealers-in-single-cone-obturation-a.md)

> **Executive GIST:** - This study evaluated the impact of **ultrasonic activation** on **calcium silicate sealers** during root canal obturation. - Forty single-rooted premolars were prepared and divided into groups using either **Angelus Bio-C Sealer** or **TotalFill BC Sealer**. - The samples were either treated with ultrasonic activation or left untreated before analysis. - Findings indicated TotalFill BC Sealer with ultrasonic activation showed the highest porosity, while Angelus Bio-C Sealer without activation showed the lowest, although differences were not statistically significant. - Notably, interfacial gaps were more prevalent than internal voids across all groups. - Total porosity was significantly higher in the cervical third of the root canals compared to other areas, highlighting the distribution of voids impacted by the obturation process.

### 19. [Within‑mouth spillover: Impact of dental restorations on neighboring teeth periodontal status](https://medichelpline.com/clinical-feed/medrxiv-8-within-mouth-spillover-of-dental-restorations-on-periodontal-status.md)
- **Source:** medRxiv (Clinical Preprints) | **Published:** 2026-08-14
- **Detail Markdown URL:** [Within‑mouth spillover: Impact of dental restorations on neighboring teeth periodontal status](https://medichelpline.com/clinical-feed/medrxiv-8-within-mouth-spillover-of-dental-restorations-on-periodontal-status.md)

> **Executive GIST:** - This prospective analysis used tooth‑surface data from SHIP cohorts (SHIP‑START follow‑ups 1–3: N=2,715/1,982/1,397; SHIP‑TREND: N=2,123) to test whether a restored tooth affects the periodontal status of adjacent teeth (a **within‑mouth spillover**). - Baseline exposure variables were presence of an **own restoration** and **neighbouring‑tooth restorations**; follow‑up periodontal outcomes included **probing depth (PD)**, **clinical attachment level (CAL)**, **bleeding on probing (BOP)** and presence of deep pockets (PD ≥4 mm). - The primary analytic approach combined a neighbourhood‑exposure mixed model with generalized propensity‑score adjustment; two additional corroborating estimators were applied to test robustness. - Findings: an **own restoration** was associated with worse periodontal status at that surface (reported crown PD exp(beta) up to **1.10**). - Neighbouring‑tooth restorations increased focal‑tooth **PD** (spillover exp(beta) **1.03–1.05**) and raised the risk of deep pockets (risk ratio up to **1.25**). Effects on **CAL** and **BOP** were not consistently observed. - The spillover effect declined with increasing tooth‑lag and approached the null by two to three teeth in most estimators, indicating a local neighbourhood gradient. - Ignoring interference from neighbouring teeth modestly inflated the estimated direct effect of an own restoration. An opposing‑tooth negative control showed no effect, while untreated caries produced a similar pattern to restorations. - Ethics: SHIP‑START and SHIP‑TREND were approved by the University of Greifswald ethics committee and conducted under the Declaration of Helsinki with informed consent. - Data are available from Forschungsverbund Community Medicine under license; access details and restrictions are reported by the authors. - The study is a preprint and has not been peer reviewed; authors declared no competing interests and provided supplementary material and data/code links.

### 20. [Dental Unit Waterline Compliance: Why Practices Are Moving from Tablets to Cartridges](https://medichelpline.com/clinical-feed/off-the-cusp-0-from-failed-waterline-tests-to-reliable-compliance-why-more-practices-are.md)
- **Source:** Off the Cusp Clinical | **Published:** 2026-08-13
- **Detail Markdown URL:** [Dental Unit Waterline Compliance: Why Practices Are Moving from Tablets to Cartridges](https://medichelpline.com/clinical-feed/off-the-cusp-0-from-failed-waterline-tests-to-reliable-compliance-why-more-practices-are.md)

> **Executive GIST:** - Failing a dental unit waterline (DUWL) test disrupts schedules, undermines team confidence, and affects patient perception of safety. Practices commonly use **waterline treatment tablets**, but recurring failures highlight their reliance on strict protocol adherence. - Tablet programs can fail due to human error, variability in source water quality, and biofilm resilience after contamination events. Tablets are dependent on consistent staff execution. - Cartridge-based, self-contained systems such as **DentaPure cartridges** deliver continuous antimicrobial treatment at the source, offering **always-on protection**, immediate readiness (no dissolution wait), and reduced variability tied to staff workflows. - Additional cartridge advantages reported include **EPA-registered** technology, simplified protocols, fewer training demands, no tablet fragments to clog handpieces, and reduced staff exposure to treatment chemicals. - Common barriers to adoption are perceived higher up-front costs and change management concerns about installation, learning new protocols, and disrupting routines. When total cost of ownership factors are included (staff time, retesting, remediation, downtime), cartridges can reduce hidden costs. - Indications to reevaluate tablets and consider cartridge systems include repeated DUWL test failures, increased staff time managing protocols, inconsistent compliance across team members, and a desire to streamline infection prevention. - Cartridge systems are presented as shifting practices from reactive remediation to proactive, continuous control. Patterson Dental and DentaPure cartridges are cited as sources for solutions and purchase. - The source emphasizes that cartridge systems are designed to be simple to implement and maintain and typically require minimal ongoing attention compared with daily or weekly tablet regimens.

### 21. [Inulin supplementation trial to modulate gut microbiota in oral lichen planus: double-blind RCT pr](https://medichelpline.com/clinical-feed/plos-one-4-study-protocol-effect-of-inulin-supplementation-on-gut-microbiota-in-patients.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-13
- **Detail Markdown URL:** [Inulin supplementation trial to modulate gut microbiota in oral lichen planus: double-blind RCT pr](https://medichelpline.com/clinical-feed/plos-one-4-study-protocol-effect-of-inulin-supplementation-on-gut-microbiota-in-patients.md)

> **Executive GIST:** - This protocol describes a multicentre, double-blind, randomised, placebo-controlled parallel-group trial testing whether **inulin** supplementation modifies the **gut microbiota** in patients with **oral lichen planus (OLP)**. - The trial will enrol 80 histopathologically confirmed OLP patients, randomised 1:1 to receive either inulin (8 g/day) or a maltose placebo for 4 weeks alongside standard care. - Study timeline: 2-week pre-observation, 4-week intervention, 4-week post-observation for a total of 10 weeks; baseline assessments at Week 2 and primary endpoint at Week 6 (end of intervention). - Primary outcome: change in the relative abundance of prespecified **butyrate-producing gut bacteria** from baseline to Week 6. - Secondary outcomes: changes in gut microbial diversity, salivary microbiota composition, faecal short-chain fatty acid (SCFA) concentrations, peripheral blood regulatory T-cell (Treg) counts, routine blood parameters, and clinical symptoms of OLP. - Analyses will follow the intention-to-treat principle with appropriate between-group statistical comparisons; details of statistical methods are reported in the protocol. - Conducted at Kyushu University Hospital and Okayama University Hospital; Kyushu University coordinates trial operations and data management. - Key exclusions: recent antibiotic use (within 3 months), recent hospitalisation, pregnancy, known allergy to inulin/Asteraceae, or investigator-determined ineligibility. - Trial registration: UMIN-CTR UMIN000060840; inulin product (Inulia® IQ) and maltose placebo provided in-kind by commercial partners; funders had no influence on study design or reporting. - Data sharing: raw 16S rRNA sequencing data will be deposited in DDBJ SRA after trial completion; participant-level and processed data will be made available as supporting information per ethics and consent. - This trial aims to provide randomized placebo-controlled evidence on whether a prebiotic can restore depleted **butyrate-producing bacteria** and associated immunological markers in OLP patients.

### 22. [3D Spatiotemporal Analysis of Condylar Remodeling After Conservative Treatment of Pediatric Sagitt](https://medichelpline.com/clinical-feed/pubmed-42587113.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-13 | DOI: [10.1007/s00784-026-07079-0](https://doi.org/10.1007%2Fs00784-026-07079-0)
- **Detail Markdown URL:** [3D Spatiotemporal Analysis of Condylar Remodeling After Conservative Treatment of Pediatric Sagitt](https://medichelpline.com/clinical-feed/pubmed-42587113.md)

> **Executive GIST:** - Objective: Evaluate **condylar remodeling** and the influence of the **temporomandibular joint (TMJ) disc** in growing patients with sagittal fractures of the mandibular condyle (SFMC) managed non‑surgically. - Study design: Retrospective imaging study of 28 children covering 43 SFMC joints with multimodal three‑dimensional reconstructions from CT and MRI performed before treatment and at 3, 6, and 12 months after treatment. - Treatment protocol: All patients received closed, conservative management consisting of full‑arch soft **occlusal splints** plus adjunctive mouth‑opening exercises; no surgical fixation was performed. - Imaging and analysis: CT and MRI datasets were fused using multimodal image registration to assess temporal volumetric change and spatial patterns of bone resorption and formation relative to disc coverage. - Main temporal findings: Condylar volume decreased significantly from pre‑treatment to 3 months (Phase P1, P = 0.009), showed no significant change between 3 and 6 months (Phase P2, P = 0.977), and increased significantly between 6 months and 12 months (Phase P3, P = 0.009). - Spatial pattern: Bone formation was concentrated in areas covered by the articular disc; root mean square (RMS) remodeling values differed significantly between disc‑covered and non‑disc‑covered regions (P = 0.024). - Interpretation: Remodeling after conservative treatment is dynamic—initial resorption is followed by delayed bone formation—and the **TMJ disc** appears to play a critical guiding role in favorable bone regeneration. - Clinical implication: Functional conservative management that preserves or restores disc position and function may be important to optimize long‑term condylar remodeling in pediatric SFMC. - Ethics and disclosures: Study approved by the Peking University Biomedical Ethics Review Committee (Approval No. PKUSSIRB-2025111113). Authors declared no competing interests. - Other notes: Specific demographic breakdowns, exact age range, detailed functional outcomes, and statistical methods beyond reported p‑values were not fully detailed in the abstract and therefore are not reported here.

### 23. [Make Waterline Testing Routine: Practical Steps to Improve DUWL Compliance](https://medichelpline.com/clinical-feed/off-the-cusp-0-turn-waterline-testing-into-a-routine-not-a-risk.md)
- **Source:** Off the Cusp Clinical | **Published:** 2026-08-12
- **Detail Markdown URL:** [Make Waterline Testing Routine: Practical Steps to Improve DUWL Compliance](https://medichelpline.com/clinical-feed/off-the-cusp-0-turn-waterline-testing-into-a-routine-not-a-risk.md)

> **Executive GIST:** - Inconsistent waterline testing creates compliance gaps because tests are often delayed or skipped when practices are busy. - Common barriers to regular testing include slow result turnaround, complicated procedures, extra equipment needs, cost concerns, and busy schedules. - Simplifying the process reduces friction; tests that are quick and easy are more likely to be completed reliably. - **FASTCheck15®** from Sterisil delivers results in about 15 minutes without incubation or extra equipment and presents a clear pass/fail indicator, eliminating colony counting or subjective color interpretation. - FASTCheck15 detects bacteria above 500 CFU/mL and is intended to help practices determine whether water meets recommended standards; it enables same-appointment action when a problem is detected. - Waterline maintenance should be viewed as a repeatable system rather than a single-product approach: frequent monitoring, verified treatment protocols, and readily available supplies form a closed-loop process. - Routine testing leads to fewer surprises, less troubleshooting, improved compliance confidence, and a better patient experience. - A practical, sustainable DUWL protocol is one that fits the team’s workflow and can be executed consistently—making testing a daily or weekly routine rather than an occasional task. - Patterson Dental positions itself as a partner to help practices build effective, maintainable workflows and supply the necessary testing and treatment products to integrate testing into infection prevention programs. - The overall message: simplify testing so it becomes habitual, not risky—combine easy testing tools with consistent treatment and maintenance to support long-term water quality and compliance.

### 24. [Microbial community shifts and network reorganization across caries-associated oral niches](https://medichelpline.com/clinical-feed/biorxiv-23-ecological-trajectories-and-microbial-network-reorganization-across-caries.md)
- **Source:** bioRxiv (Biomedical Preprints) | **Published:** 2026-08-12
- **Detail Markdown URL:** [Microbial community shifts and network reorganization across caries-associated oral niches](https://medichelpline.com/clinical-feed/biorxiv-23-ecological-trajectories-and-microbial-network-reorganization-across-caries.md)

> **Executive GIST:** - The study used **16S rRNA gene sequencing** to compare oral microbiomes from paired supragingival plaque and carious dentin in patients with dental caries, and supragingival plaque from healthy controls. - **Caries-associated supragingival plaque** exhibited higher microbial diversity than healthy supragingival plaque. - **Carious dentin** samples showed reduced diversity relative to plaque, placing sample types along a health → plaque → dentin ecological continuum. - Network association analysis revealed distinct community structures: the **dentin network** had greater density and lower modularity than plaque networks. - By combining differential-abundance and network centrality metrics, the authors identified taxa linked to the dentin niche; specific taxon names were not reported in the source. - A sparse logistic regression model using three genera discriminated plaque from dentin in patient-grouped cross-validation (AUROC 0.780; AUPRC 0.718). - The work is cross-sectional and generates candidate microbiome features for future validation in independent, clinically relevant cohorts. - No competing interests were declared. - The preprint was posted August 12, 2026, on bioRxiv and is available under a CC-BY-NC-ND 4.0 license.

### 25. [PRF vs EMD as Adjuncts to Non‑Surgical Periodontal Therapy: Split‑Mouth Randomised Trial Results](https://medichelpline.com/clinical-feed/pubmed-42583789.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-12 | DOI: [10.3290/j.ohpd.c_2750](https://doi.org/10.3290%2Fj.ohpd.c_2750)
- **Detail Markdown URL:** [PRF vs EMD as Adjuncts to Non‑Surgical Periodontal Therapy: Split‑Mouth Randomised Trial Results](https://medichelpline.com/clinical-feed/pubmed-42583789.md)

> **Executive GIST:** - This split‑mouth randomised clinical trial compared **enamel matrix derivative (EMD)** and **platelet‑rich fibrin (PRF)** as adjuncts to scaling and root planing (SRP) in non‑surgical management of Stage II/III, Grade A/B periodontitis. - Fifteen participants were enrolled and 13 completed the 6‑month follow‑up; each patient contributed two interproximal sites randomly allocated to EMD or PRF after full‑mouth SRP. - EMD sites received subgingival ethylenediaminetetraacetic acid (EDTA) conditioning before application; PRF was prepared using a standard horizontal centrifugation protocol. - Clinical outcomes measured at baseline and 6 months included **probing depth (PD)**, gingival margin (GM) position, **clinical attachment level (CAL)**, and **bleeding on probing (BOP)**. - Both adjuncts produced significant within‑group clinical improvements at 6 months: mean PD reductions were 1.1 ± 0.6 mm for EMD and 1.2 ± 0.7 mm for PRF; mean CAL gains were 1.1 ± 0.7 mm (EMD) and 1.1 ± 0.8 mm (PRF). - Gingival margin positions were stable in both groups. **BOP** decreased substantially (EMD: 77% to 23%; PRF: 85% to 31%). - Intergroup comparisons showed no statistically significant differences for PD (p > 0.999), GM (P = 0.174), or CAL (P = 0.556). - Frequency distribution analysis indicated conversion of deep sites (≥ 6 mm) to ≤ 6 mm at 6 months in 100% of EMD sites and 90% of PRF sites. - Authors conclude EMD and PRF yield comparable clinical outcomes as adjuncts to **non‑surgical periodontal therapy**, supporting clinician flexibility in choosing either biomaterial based on preference, availability, and cost. - The source does not report detailed adverse events, long‑term outcomes beyond 6 months, or specific statistical power calculations in the abstract provided.

### 26. [Designing a Child-Centered Dental Practice: The Story of Bloomy’s Pediatric Dentistry](https://medichelpline.com/clinical-feed/off-the-cusp-0-building-bloomy-s-a-vision-for-a-child-friendly-dental-practice-comes-to-life.md)
- **Source:** Off the Cusp Clinical | **Published:** 2026-08-11
- **Detail Markdown URL:** [Designing a Child-Centered Dental Practice: The Story of Bloomy’s Pediatric Dentistry](https://medichelpline.com/clinical-feed/off-the-cusp-0-building-bloomy-s-a-vision-for-a-child-friendly-dental-practice-comes-to-life.md)

> **Executive GIST:** - Dr. Ackeilia Heatrice created Bloomy’s Pediatric Dentistry to deliver a deliberately **child-centered** clinical experience that could not be achieved working under others. - The practice environment emphasizes color, whimsy, and scaled design elements such as a bright yellow child-sized door, color-coded treatment rooms, and an open-air hygiene area with chairs in different bright colors to help put children at ease. - Dr. Heatrice engaged a Patterson representative, Phil Catanzaro, after meeting him at an inner-city clinic for underserved patients; she later sought his second opinion when she had concerns about suggestions from a management company overseeing her build. - Equipment specialist Chris White identified mismatches between the proposed floor plan and Dr. Heatrice’s vision, made on-the-spot adjustments using his iPhone, and helped develop a revised floor plan and equipment plan aligned with her goals. - A CAD/CAM specialist, Vince Sciore, supported implementation of **CAD/CAM** and child-friendly technology to enable pain-free, trauma-minimizing procedures—technology that contributed to positive patient experiences and rapid word-of-mouth growth. - Positive outcomes led Dr. Heatrice to refer her husband to the Patterson team for his oral and facial surgery practice, and Patterson representative Phil Catanzaro sent his daughter and grandchildren to Bloomy’s, illustrating mutual trust built through the process. - Patterson Dental’s role in the story is positioned as partnership-oriented, offering “Trusted Expertise, Unrivaled Support,” and helping practices of varied sizes pursue practice-specific goals. - Specific operational metrics, patient volumes, financial details, timelines, and technical specifications of equipment and CAD/CAM systems were not reported in the source article.

### 27. [Comparison of Public Dental Expenditures and Reimbursement: Taiwan NHI Global Budget vs OECD (2010](https://medichelpline.com/clinical-feed/bmj-open-12-decades-of-dental-care-evolution-a-cross-national-comparative-study-on-public.md)
- **Source:** BMJ Open | **Published:** 2026-08-11
- **Detail Markdown URL:** [Comparison of Public Dental Expenditures and Reimbursement: Taiwan NHI Global Budget vs OECD (2010](https://medichelpline.com/clinical-feed/bmj-open-12-decades-of-dental-care-evolution-a-cross-national-comparative-study-on-public.md)

> **Executive GIST:** - This longitudinal comparative study evaluated national-level **public dental expenditures**, reimbursement standards, and policy shifts in Taiwan under the **NHI Global Budget** and in 38 OECD countries from 2010 to 2025. - Data sources included the OECD Health Statistics database and Taiwan MOHW NHI annual reports and fee schedules; monetary figures were adjusted using healthcare-specific **PPP** and CPI. - Primary outcomes measured were dental expenditure as a share of GDP, **per capita dental spending (PPP-adjusted)**, and real reimbursement values for four standardized procedures (full-mouth scaling, composite filling, molar root canal treatment, simple extraction). - Secondary outcomes examined the preventive versus restorative spending mix, point-value volatility within Taiwan’s global budget system, and effects of policy interventions on expenditure trends. - Between 2010 and 2025 Taiwan’s dental spending remained 0.52%–0.68% of GDP, below the OECD range of 0.89%–1.08% of GDP. Taiwan’s **per capita dental spending** rose from PPP$145 to PPP$198, while the OECD average rose from PPP$289 to PPP$412. - PPP-adjusted reimbursements for complex procedures in Taiwan (notably molar endodontics) were about 35%–37% of levels observed in Japan and Germany. - Interrupted time-series (ITS) analysis identified a statistically significant immediate decline in dental claims volume after COVID-19 onset (Q2 2020); the source did not report the exact p-value or effect size in the extracted text. - Authors interpret Taiwan’s Global Budget as effective for **cost containment** and maintaining accessibility but note possible reliance on implicit labour-cost subsidies by dental professionals. - With Taiwan’s transition toward a super-aged society, the study warns of sustainability pressures under a volume-based payment model and suggests exploring **value-based reimbursement**, point-value floors for complex procedures, and expanded geriatric dental benefits to support equity and quality of care. - Details on some statistical estimates and certain ITS parameters were not provided in the source excerpt and therefore are not reported here.

### 28. [Precision periodontology: integrating omics, biomarkers, and 3D imaging into clinical decisions](https://medichelpline.com/clinical-feed/pubmed-42567900.md)
- **Source:** PubMed / NCBI | **Published:** 2026-08-08 | DOI: [10.1007/s00784-026-07059-4](https://doi.org/10.1007%2Fs00784-026-07059-4)
- **Detail Markdown URL:** [Precision periodontology: integrating omics, biomarkers, and 3D imaging into clinical decisions](https://medichelpline.com/clinical-feed/pubmed-42567900.md)

> **Executive GIST:** - Precision periodontology seeks to integrate molecular diagnostics, **genomics**, microbiome profiling, host-response biomarkers, and advanced imaging into periodontal clinical decision-making. - The review critically appraises evidence on subgingival microbiome testing, single-SNP genotyping, epigenetic markers, salivary and gingival crevicular fluid biomarkers, the aMMP-8 point-of-care test, three-dimensional imaging (CBCT), and artificial intelligence models. - Literature search covered PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library for 2010–2025, prioritising meta-analyses, systematic reviews, longitudinal studies, and guideline documents. - Findings: microbiological testing has clearly defined but narrow clinical indications; single-SNP genotyping has not shown clinical utility proportional to its cost; epigenetic and many biomarker data remain investigational. - The aMMP-8 point-of-care assay is among the most extensively studied host-response tools and may provide adjunctive value in selected monitoring and peri-implant situations, but evidence is insufficient for routine use. - CBCT can influence surgical planning by characterising defect morphology when three-dimensional detail changes management decisions. - AI-based predictive models show potential but currently lack prospective clinical validation necessary for routine implementation. - Conclusions align with the 20th EFP Workshop Consensus Report: precision tools augment rather than replace conventional staging and grading. - The authors propose a conceptual decision-threshold framework to help selectively consider molecular diagnostics and advanced imaging when these tools are likely to add meaningful information; this framework is presented as research-oriented, not a validated clinical algorithm. - Clinically, the review offers a structured, evidence-based approach to identify scenarios where **molecular diagnostics**, **host-response biomarkers**, and **3D imaging** may alter treatment choices and supports further implementation research.

### 29. [Geometric morphometric analysis of sexual dimorphism in maxillary first and second molars](https://medichelpline.com/clinical-feed/plos-one-9-geometric-morphometric-analysis-of-maxillary-molar-sexual-dimorphism-a-cross.md)
- **Source:** PLOS ONE (Medicine) | **Published:** 2026-08-07
- **Detail Markdown URL:** [Geometric morphometric analysis of sexual dimorphism in maxillary first and second molars](https://medichelpline.com/clinical-feed/plos-one-9-geometric-morphometric-analysis-of-maxillary-molar-sexual-dimorphism-a-cross.md)

> **Executive GIST:** - Objective: Evaluate **sexual dimorphism** in shape and size of permanent maxillary first (UM1) and second molars (UM2) using three-dimensional **geometric morphometric** analysis. - Study design: Cross-sectional analysis of digitized pretreatment dental casts from 60 males and 60 females drawn by convenience sampling; participants were required to have intact maxillary posterior teeth and no history of caries, trauma, restorations, craniofacial anomalies, syndromes, or systemic conditions affecting tooth development. - Regional sampling: Individuals classified as from the Dakshina Kannada region if participant, parents, and grandparents were born and resident there; full population homogeneity was not assumed. - Data acquisition: Casts scanned with a laser surface scanner. Twenty-eight three-dimensional landmarks based on anatomical and geometric points were placed using SlicerMorph software. - Shape analysis methods: Landmark data processed with Procrustes superimposition. Principal components analysis (PCA), regression, and discriminant function analysis were used to assess shape variation, allometry, and group differences. - Size results: Centroid size did not differ significantly between sexes for UM1 and UM2 (reported p > 0.05). - Shape results: No significant shape difference for UM1 (p = 0.15); significant shape difference for UM2 (p = 0.01). - Allometry: Allometric effects detected in both molars. Contribution of size to shape change was greater in UM2 (6.96%) than UM1 (2.39%) with reported p < 0.001. - Discriminant analysis: Patterns of shape variation between sexes were identified by discriminant function analysis, but the authors cautioned interpretation because no cross-validation was performed. - Conclusion: 3D **geometric morphometric** analysis detected significant sexual dimorphism in the shape of the maxillary second molar and supports the method’s utility for assessing tooth-shape variation; authors recommend larger and more diverse samples to validate findings. - Ethics and data: Institutional ethics approval obtained (reference 20018, dated 16 March 2020); written informed consent obtained; datasets and landmark coordinates are publicly available in Figshare (DOI provided in the article). - Funding and conflicts: Study partially funded by the Science and Engineering Research Board (SERB), India (file number CRG/2020/001057). Authors declared no competing interests. - Publication details: Manuscript received 6 November 2025, accepted 18 July 2026, published 7 August 2026 in PLoS ONE; citation and DOI provided in the source.

### 30. [Hcp Enables Porphyromonas gingivalis Persistence in Nitrate-Reducing Oral Biofilms](https://medichelpline.com/clinical-feed/biorxiv-9-nitrate-reducing-commensals-reshape-oral-biofilm-ecology-and-reveal-hcp-as-a.md)
- **Source:** bioRxiv (Biomedical Preprints) | **Published:** 2026-08-07
- **Detail Markdown URL:** [Hcp Enables Porphyromonas gingivalis Persistence in Nitrate-Reducing Oral Biofilms](https://medichelpline.com/clinical-feed/biorxiv-9-nitrate-reducing-commensals-reshape-oral-biofilm-ecology-and-reveal-hcp-as-a.md)

> **Executive GIST:** - Dietary **nitrate** supplementation promotes microbial generation of **reactive nitrogen species (RNS)** including nitrite and nitric oxide, which can suppress oral pathobionts. - The hybrid cluster protein (**Hcp**) was previously identified as a major **nitrosative stress** defense factor in **Porphyromonas gingivalis**, with ~170-fold induction of hcp after nitrite exposure and required for survival at physiological nitrite levels. - This study used human ex vivo plaque biofilms and a defined nine-species biofilm model to test Hcp's role in P. gingivalis persistence under nitrate-reducing conditions. - In ex vivo plaque biofilms, Hcp was essential for P. gingivalis survival under both baseline and nitrate-supplemented conditions. - In the nine-species model, nitrate reduction suppressed wild-type P. gingivalis, while deletion of hcp (Δhcp) caused complete clearance of P. gingivalis from the community. - Metatranscriptomic analysis showed that nitrate-induced hcp expression was not unique to P. gingivalis but part of a coordinated **nitrosative stress response** among oral anaerobes such as Prevotella intermedia, Fusobacterium nucleatum, and Veillonella atypica. - Nitrate reduction disrupted a previously synergistic interaction between Veillonella spp. and P. gingivalis, converting it into an inhibitory microenvironment that limited pathogen survival. - The authors conclude that **Hcp-mediated nitrosative stress resistance** is a major determinant of P. gingivalis fitness within nitrate-reducing biofilms and that RNS are an ecological force shaping interactions between commensal nitrate reducers and periodontal pathogens. - These findings provide a mechanistic framework linking dietary nitrate metabolism to oral microbiome homeostasis. - The work is presented as a preprint and has not been peer reviewed.

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